Various pills
(Flickr user Keith Ramsey)

On Thursday, June 20, the King County Board of Health unanimously approved a Rule and Regulation establishing an industry-funded product stewardship model for managing unwanted and surplus drugs and medicines in King County. King County will become the second County in the nation (following Alameda County, California) to adopt such a program; British Columbia has had a similar program in place for many years. As Vice-Chair of the Board of Health, I served on the subcommittee that worked for the last year to develop this program under the leadership of Board Chair County Councilmember Joe McDermott.

The program requires drug producers to fund and operate a system that will provide secure containers at pharmacies and law enforcement agencies where people can deposit unwanted drugs and medicines. The products collected will be taken to a hazardous waste incinerator for disposal.

The product stewardship model assigns responsibility for the safe disposal of products to the industries that produce them. Washington State has already adopted such a program for electronic devices such as computers and televisions. The product stewardship model is an accepted best practice for a zero waste strategy, and the City’s adopted zero waste policy calls for product stewardship plans for a number of materials.

Drugs and medicines are good candidates for product stewardship because there is very good information about the producers, who are heavily regulated by the federal government, so a stewardship model can be implemented relatively easily. There is also a compelling need.

Most people dispose of unwanted drugs and medicines by putting them in the trash or down the drain. Neither of these are great for the environment. Many medicines are very toxic, and should not be put in landfills. Sewage treatment plants are not designed to break down these chemicals, and the drugs can flow through them into Puget Sound, where they can poison or contaminate ecosystems. Incineration is the preferred mode for disposal.

There are also risks to leaving unwanted drugs and medicines around the house. Accidental poisoning, especially of children, is a significant problem. Many drugs and medicines can be attractive (although dangerous) intoxicants, and leaving medicines around the house can lead to drug abuse problems, especially if they are readily available to teenagers.

The take back program requires the producers of drugs to form a cooperative organization to manage the program. Producers that wish to operate an independent plan can propose their own version. The plan will be reviewed and approved by Public Health. Drug producers are responsible for the collecting, transporting, and disposing of the waste, as well as administration, education/promotion, and evaluation. The program may not require a fee from consumers, and participation by pharmacies and law enforcement agencies is on a voluntary basis. There are requirements for the program to recruit and identify collection sites that will adequately and conveniently serve the County’s population. Since at least two pharmacy chains (Bartell Drugs and Group Health) are already providing collection services, and since there will be no cost to participating pharmacies, we do not anticipate that there will be any problem in finding adequate sites. The program is scheduled to begin in 2014, after allowing time for developing a plan and preparing for implementation.

While this program is enthusiastically supported by law enforcement, medical and public health professionals, and zero waste advocates, it is opposed by the pharmaceutical industry. Even though the costs (as projected by Public Health based on the successful British Columbia program and other models) are relatively modest (probably less than $1 million/annually, perhaps 2 to 4 cents per prescription), the drug companies have threatened a lawsuit to prevent the program from proceeding. They have already sued Alameda County, a suit that is expected to be decided later this year.

It is unfortunate that these companies apparently prefer the continued risks of environmental contamination, poisoning, and drug abuse to working together to operate a modest program to remedy and prevent these problems. It is especially odd because many of the same companies are peacefully cooperating in the British Columbia program. We believe that we can win a lawsuit, and look forward to having this modest, practical program go into effect in the near future.